Pubdate: Sat, 17 Mar 2001 Source: National Journal (US) Section: Health; Vol. 33, No 11 Copyright: 2001 National Journal Group Inc Contact: 1501 M St., NW #300, Washington, DC 20005 Fax: (202) 833-8069 Website: http://nationaljournal.com/njweekly/ Author: Elisabeth Frater MEDICAL MARIJUANA: THE SMOLDERING DEBATE A controversial assault on the nation's war on illegal drugs started in 1996, when a well-organized and well-funded coalition of drug law reformers and grass-roots activists put legalization of "medical marijuana" on the ballots in California and Arizona. Propelled by evidence that marijuana sometimes alleviates the symptoms or side effects suffered by some seriously ill people who do not respond to conventional medicine, the first two legalization measures proved enormously popular, winning 65 percent of the vote in Arizona and 56 percent in California. Surprised by the measures' success, the Clinton Administration mobilized within days to develop a game plan aimed at defeating similar initiatives in other states and preventing the drive to legalize medical marijuana from expanding to cover all uses of marijuana. The government's aggressive response triggered a high-profile legal clash over whether "medical necessity" is a permissible justification for violating federal drug-possession laws. That dispute will be heard by the U.S. Supreme Court on March 28. Gen. Barry McCaffrey, who was the Clinton Administration's drug czar in 1996, recalls: "My own solid judgment was that there were a ... small number of people, a few hundred, who were determined to make the use of smoked marijuana more tolerated, legal, readily available.... They've got money, and they've got energy." At McCaffrey's urging, representatives of the Justice Department, the Drug Enforcement Agency, the Office of National Drug Control Policy, and the state governments of California and Arizona met on Nov. 14, 1996, with anti-drug interest groups, including the Partnership for a Drug-Free America and Community Anti-Drug Coalitions of America. According to official notes from that session, the foes of medical marijuana lamented that they had been blindsided by "stealth legislation," and they characterized the organizers of the initiatives as "using the terminally ill as props." James E. Copple, then-president of Community Anti-Drug Coalitions of America, argued at the meeting that the other 48 states needed to be protected from medical marijuana propaganda, and he described plans to spread a counter-message in seven states. But Thomas Gede, then a special assistant attorney general of California, cautioned the group against taking more-extreme measures, such as seizing medical marijuana or arresting those who distributed it. He said he feared potential government liability if ill people suffered or died because they could not receive the medical marijuana approved by their states. DEA officials chimed in to warn that the federal court system would "grind ... to a halt" if it were flooded with relatively petty marijuana arrests. Despite federal efforts to counter it, the medical marijuana cause continued to win resounding victories at the state level: By 2000, ballot initiatives legalizing the medical use of marijuana had easily passed in Alaska, Colorado, Nevada, Oregon, Maine, and Washington. Also in 2000, Hawaii's state Legislature became the first to approve medical marijuana. Yet, state-level medical marijuana measures have proven to be imperfect vehicles for their cause, because they don't specify how the marijuana can wend its way from growers or suppliers to patients without breaking federal law. Cooperatives have been created to dispense medical marijuana in various forms, but some, including the Oakland Cannabis Buyers' Cooperative in California, have been targeted by the federal lawsuit intended to shut them down. Later this month, the U.S. Supreme Court will hear arguments in United States vs. Oakland Cannabis Buyers' Cooperative, the federal government's lawsuit to stop what it considers to be the illegal sale and distribution of marijuana by California clubs and cooperatives. The Oakland cooperative is under court order to stop dispensing marijuana while the case is pending. Now the cooperative dispenses only advice and good wishes. Jeffrey Jones, its executive director, says: "We are important to the social and beneficial atmosphere that these patients need, to keep on top of their condition and ... not give up on their life-(unlike) the cold shoulder and the indifferent hand that the federal government has offered them." The perceived threat posed by cannabis cooperatives is not that there are too many for the feds to suppress. According to the National Organization for the Reform of Marijuana Laws, there are only 30 to 40 such groups in the country. Instead, federal officials are acting out of the conviction, shared by anti-drug groups, that medical marijuana is dangerous in itself- and also is the stalking horse for efforts to legalize all marijuana use. As Betty Sembler, founder of the Drug-Free America Foundation in St. Petersburg, Fla., puts it: "First of all, I don't call it medicinal marijuana, because there is no such thing. Marijuana is medical excuse marijuana. That's all it is. The pro-drug lobby is trying to use it to say it's a natural thing to do, to burn your lungs, ruin your mind.... It's just part of a marketing agenda." Timothy Lynch, director of the criminal justice program for the libertarian Cato Institute, says, "Medical marijuana represents the first step in the direction of de-escalating the war" on drugs. Still, given the evident public support for medical marijuana, why has the government continued to fight it? Eric E. Sterling, president of the Criminal Justice Policy Foundation, thinks one reason is that the issue creates a tug-of-war "between the conservative viewpoint of traditional values and those who reject traditional values." In his view, "The war on drugs is not only a policy matter, it is a crusade." Congressional Republicans were among those pressuring federal drug fighters to combat medical marijuana. In October 1997, McCaffrey was summoned to testify before the House crime subcommittee chaired by then-Rep. Bill McCollum, R-Fla., who said he was worried about a possible medical marijuana initiative in his state and "the potential consequences of a shift in public policy toward marijuana legalization." Rep. Asa Hutchinson, R- Ark., sternly ordered McCaffrey "to be more engaged in the battle." R. Keith Stroup, the founder and executive director of the National Organization for the Reform of Marijuana Laws, says that he thinks "the Republican (congressional) leadership some time ago chose to make its opposition to the medical use of marijuana a major plank in their anti-drug war...." Stroup recalls that in 1981, McCollum and then-Rep. Newt Gingrich, R- Ga., co-sponsored a bill to allow the therapeutic use of marijuana in situations involving life-threatening illnesses. "Yet," Stroup said, "years later, when the war on drugs is running strong and the Republicans are trying to take advantage of it, they actually led the charge against medical marijuana. Nothing had changed ... except that the Republicans had taken a particular strategic position." However, it was a Democratic Administration whose drug czar and Attorney General actually challenged the marijuana cooperatives. Former drug czar McCaffrey denies that obliterating medical marijuana was a personal crusade for him and says that he considered it a trifling issue, compared with other narcotics problems. He adds that he viewed the medical marijuana conflict largely as a medical matter that should be decided in the "forum of science and medicine." Many anti-drug organizations agree with McCaffrey's view. For example, Howard Simon, spokesman for Partnership for a Drug- Free America, says: "Voters should not circumvent recognized scientific and medical processes by deciding what constitutes safe and effective medicine via the ballot box. Let's not politicize it. Let's not emotionalize it.... Let's let the scientists and researchers give us the answer-the same way the (Food and Drug Administration) would look at any other proposed medication." In January 1997, McCaffrey commissioned the National Academy of Sciences' Institute of Medicine to assess the potential health benefits and risks of marijuana and THC, the primary psychoactive ingredient in marijuana. Both sides found some support for their views in the NAS report, which was released in March 1999. Pro-marijuana groups embraced the researchers' conclusion that "there are some limited circumstances in which we recommend smoking marijuana for medical uses." The report found that marijuana has "potential therapeutic value" when used for pain relief, control of chemotherapy-induced nausea, and appetite stimulation in AIDS patients. The government latched onto another of the report's conclusions: "Although marijuana smoke delivers THC and other cannabinoids to the body, it also delivers harmful substances, including most of those found in tobacco smoke." The American Medical Association, which is reviewing its position, recommends "adequate and well-controlled studies of smoked marijuana" and urges the National Institutes of Health to develop smoke-free methods of administering marijuana to patients. According to a March 1999 Gallup Poll, although 69 percent of American adults say they oppose the general decriminalization of marijuana, 73 percent favor making marijuana "legally available for doctors to prescribe in order to reduce pain and suffering." Most observers doubt that the outcome of the medical marijuana case now before the Supreme Court will provide the final word on the larger controversy. Sterling predicts that public opinion will eventually force the federal government to "change its position, over the objections of DEA and the Justice Department." Sterling concluded: "The American people understand that making marijuana available to sick people to relieve their conditions is nothing like legalizing marijuana for other kinds of uses.... (Medical marijuana) is not going to drive a stake into the heart of law enforcement, as some tend to exaggerate." - --- MAP posted-by: Beth